Archive by Author

Laura Hewitson’s Stinker

18 May

Sorry about the title, I couldn’t find a word to rhyme with her last name to infer wrong-doing a la Age of Autism’s ‘Grinker’s Stinker. Anyway….

Meet Laura Hewitson. Laura is the lead and joint author of a trio of papers presented at this years IMFAR as posters.

These papers (also shredded by Orac) purport to show how it is possible to mimic the 1999 US vaccine schedule and give monkeys autism as a reult. Never mind the fact that the results reported don’t sound or present anything like autism (<em>”survival reflexes, tests of color discrimination and reversal, and learning sets”</em> huh??), lets look at Laura Hewitson a bit more closely then I managed to in a quick 10 min post last time.

As I mentioned at the time, Laura Hewitson claims affiliation with DAN! Thats enough in my book to place a rather large red flag against her impartiality.

Now I’ve learnt that her entanglement with the vaccine/autism hypotheses goes very much further than that.

It turns out that Hewitson’s partner is Dan Hollenbeck, an Age of Autism contributor. Hollenbeck owns the website FightingAutism.org and in the top right hand corner of the FightingAutism website are the words:

FightingAutism is now part of Thoughtful House Center for Children.

And we all know who is the big cheese at THoughtful House don’t we? That’s right – one Andrew Wakefield. He’s also the co-author to the three studies poster presented at IMFAR.

Hollenbeck’s asociation with Thoughtful House goes beyond just having a website affiliated with them however. He’s also an employee of Thoughtful House.

Director of Information Technology for Thoughtful House, Dan Hollenbeck received his Bachelor of Science degree in Electrical and Computer Engineering from the University of Wisconsin-Madison in 1992

….

When their son was diagnosed with autism in 2001, the Hollenbecks relocated from Oregon to Pittsburgh in order to accept employment as an Information Technology Manager for a large NIH (National Institutes of Health)-funded medical research organization

….

He is also on the Board of Directors, as well as the Research Committee, for SafeMinds…

So, here we are with three poster presentations from a woman who has an autistic son, affiliated with DAN!, is married to the Thoughtful House IT guy (who also happens to be on the Board of Directors of SafeMinds) and these afore-mentioned poster presentations are also co-authored by Andrew Wakefield.

I wonder just how impartial this science can be?

How about when we throw one more fact into the equation?

437. Laura Hewiston (sic) and Dan Hollenbeck on behalf of Joshua Hollenbeck, Dallas, Texas, Court of Federal Claims Number 03-1166V

That’s right. Hewitson and Hollenbeck are suing HHS for vaccine injury visited upon their son Joshua.

Now, lets turn our attention to IMFAR where Hewitson made her three poster presentations. INSAR have regulations governing the papers and abstracts submitted.

INSAR requires authors to disclose their sources of contributed support (commercial, public, or private foundation grants, and off-label use of drugs, if any). INSAR also requires authors to signify whether there may be a real or perceived conflict of interest. Any potential for financial gain that may be derived from reported work may constitute a potential conflict of interest.”

Now, maybe Hewitson did note the fact that:

a) Her husband is an employee of an organisation that makes money from treating what they allege is vaccine caused autism.

b) She has an autistic child.

c) Said child has been registered for compensation for alleged vaccine damage resulting in autism (I assume they’re part of the Omnibus proceedings then?)

But if she did, then it isn’t recorded in the abstracts posted on the Age of Autism website.

Should Parents With a Stake in Vaccine Litigation be Disallowed From Commenting?

17 May

As I’d imagine most readers would agree, no, parents with a stake in vaccine litigation should not be disallowed from commenting simply on the basis that they have a conflict of interest. It doesn’t matter if the conflict of interest runs in the millions of dollars. Should Jon Poling, for example, be disallowed from commenting? I don’t think so in the least. In fact, some of us wish he’d be more forthcoming with information about his daughter’s case.

So why am I bringing this up? Apparently, Kim Stagliano does think it is a good idea for people with conflicts of interest in this debate to shut up, judging from a recent post of hers.

DR. OFFIT’S CONFLICT OF INTEREST SHOULD DISALLOW HIM FROM COMMENTING

(See also Orac’s take)

For those who aren’t familiar with Kim Stagliano, she’s the parent of two autistic little girls, one of whom, I understand, has never been vaccinated. Some call Kim the poster child of autism genetics. But I digress.

All of this got me thinking about conflicts of interest, though, and I’ve come to the conclusion that not all conflicts of interest are created equal. Let’s take monetary conflicts of interest, for starters. I can identify 3 groups in the autism community that do not have monetary conflicts of interest.

  1. Parents with no stake in vaccine litigation.
  2. Autistic people with no stake in vaccine litigation (which would include all autistic adults).
  3. Scientists and professionals who do not make a living from research or litigation on autism or related matters.

This is a rough characterization, of course. It’s always possible for parents or autistic adults to have conflicts of interest through their employment, for example. I doubt this is usually the case, nevertheless.

Some might say I’m biased, as I have basically identified the Autism Hub and friends as not having significant monetary conflicts of interest. Be that as it may, I believe it’s a roughly accurate characterization, and I’m willing to listen to arguments to the contrary.

But let’s face it. None of us are free of conflicts of interest in general. We might oppose attempts to stigmatize us, especially if said stigmatization is based on almost certainly false claims. We might have a huge emotional investment in the outcome of our kids. We might see litigation-motivated alt-med as a threat to the integrity of science, and so forth.

The point is that if Kim were right, then none of us, from any side of the debate, should be allowed to comment. Beyond arguments about freedom of speech, this is obviously nonsensical. Kim Stagliano should reconsider her statement.

A secondary point is that there are conflicts of interest and there are conflicts of interest. It seems to me that someone attempting to make millions in court, or someone who has been actually payed nearly millions to produce evidence of causation (which is not speculation on my part) has a much bigger conflict of interest than, say, someone who is employed by the government or someone who has served in the advisory panel of a pharmaceutical company. But again, none of this should disallow someone from commenting. It can be used to make a judgement about trustworthiness, sure.

Monkeying Around

16 May

Its IMFAR time again and over on Age of Autism (thanks to Kelli Ann Davies for this priceless hat tip) they’re getting all het-up:

SICK MONKEYS: RESEARCH LINKS VACCINE LOAD, AUTISM SIGNS
The first research project to examine effects of the total vaccine load received by children in the 1990s has found autism-like signs and symptoms in infant monkeys vaccinated the same way. The study’s principal investigator, Laura Hewitson from the University of Pittsburgh, reports developmental delays, behavior problems and brain changes in macaque monkeys that mimic “certain neurological abnormalities of autism.”

Autism signs? Not just ‘autism? Research hasn’t linked vaccine load to autism?

I’d love to tell you more about this (and the other two accompanying studies on the same subject) but I can’t. Why? Well, because they’re not actually _studies_ as such. They’re poster presentations.

So, what’s a poster presentation? Well, its exactly what it sounds like – its a researcher, making a poster of their research and standing beside it for an hour, hoping other people find it enough of interest to look at. A few popular ones are sometimes asked to be presented orally. There are usually at least a hundred different poster presentations at a conference. It mostly depends on teh size of the conference hall.

Age of Autism’s Dan Olmsted says:

Poster presentations must go through a form of peer review before they are presented at the conference; the papers have not yet appeared in a scientific journal.

One of those two statements is true. The other is sadly not. Here are ‘the rules’ for poster presentations at IMFAR 2008.

Posterboards will have a display area 194cm wide X 84cm high. We suggest that you produce posters in A0 landscape format (120cm wide X 84cm high). Posters will be fixed to boards using sticky-back Velcro that will be supplied on site. Poster Numbers 1-60 will be located in the Champagne Terrace room, and Numbers 61-120 will be located in the Bordeaux room. In the programme a time is allocated for each poster presenter to be standing by their poster.

The page goes on to provide some helpful tips such as: ‘Less is more’ (probably no worries on that score) and ‘Use an appropriate font’. Hopefully, the team will have taken onboard the services a real typography expert such as Dr Paul King of CoMeD.

So – I can tell you next to nothing about these poster presentations. The good folk at AoA seemed oddly reluctant to link through to the abstracts.

However, I can tell you a little about the authors. The primary author seems to be Laura Hewiston of Pittsburgh University. She is registered on that page as a DAN! Doctor. She (I think its the same person) also appears here (see 953) and here.

Also listed as an author according to AoA is one AJ Wakefield. Enough said about that!

Lastly, is Steve Walker who did a poster presentation at an IMFAR in the past (can’t recall which one) which also appeared to offer support for the MMR hypothesis. Oddly, that poster presentation never made it into any kind of peer reviewed journal.

Best comment on Age of Autism comes courtesy of David Ayoub who begins with:

someone slap me!

I tell you, if that man didn’t exist, someone would have to invent him.

Autism Omnibus – Vas Aposhian

16 May

Vas Aposhian is – like Sander Greenland – an expert witness for petitioners (the families) and a professor of molecular and cellular biology as well as a professor of pharmacology.

On Day 2 and 3 he testified as to what seemed to be the main hypothesis behind the whole thiomersal/autism idea.

The basic idea is that some people are genetically predisposed to something called _mercury efflux disorder_ (plain english, they can’t get rid of mercury as well as most people can, it crosses the blood brain barrier and triggers autism). Mercury Efflux Disorder is itself an unproven hypothesis but Aposhian passionately believes in it.

He came under heavy cross exam (I won’t go through his performance whilst testifying to his own ‘side’ – we all know the basic hypothesis), that compromised a lot of day two and most of the morning of day three (the audio is released slowly so I’m a couple of days behind). The part I’m writing about today starts about an hour and a half into day three (NB: I’ve downloaded all the MP3’s and stitched them into one file).

Aposhian says that the mercury efflux hypothesis is supported by six papers:

…each piece of evidence alone leaves some doubt but taken all together the evidence implicates thimerosal/ethylmercury as the likely precipitating agent in the etiology of some of the autism spectral disorders.

Respondent counsel referred to these six papers as ‘pillars’ supporting the hypothesis. Aposhians’s pillars are:

First, Adams et al. (2007) demonstrated that teeth from autistic children contain more mercury than those from non-autistic children.

Respondent counsel asked Asphosian what he thought he could criticize about these papers he says ‘implicate thiomersal’. Regarding Adams et al, Asphosian said (and I’m paraphrasing slightly after scribbling notes furiously):

1) The number of controls should’ve been increased.
2) There were too few test subjects
3) When asked if raised mercury level was an indicator of toxicity, Asphosian answered “I don’t know”.
4) When asked if he would’ve expected mercury concentrations to vary depending on gender, Asphosian answered “Yes”.
5) When asked if Adams controlled for gender Asphosian answered, “No, he doesn’t control for gender”.
6) When asked if lead concentration of a tooth affected mercury concentration of a tooth, Asphosian answered, “I don’t know”.
7) Asphosian was asked, given the fact that the thiomersal hypothesis depended on the role of _ethyl_ mercury, what type of mercury did Adams et al measure in the teeth? Asphosian’s answer was “…did not do speciation” – in other words, he didn’t separate the types of mercury out. He recorded it all.
8) When asked if mercury levels in teeth tell you anything about amounts of mercury in the brain Asphosian replied that he didn’t know as no one had ever done that study.

These are fairly damning failings in what Asphosian’s assumptions were regarding the quality of that study. Of course, there is more wrong with the Adams paper than just the above, but these points are pretty damning. The failure to control for gender, the paucity of subjects and the fact Adams et al didn’t concentrate on ethyl-mercury raise serious questions over what exactly this study can add to the so-called Mercury Efflux Disorder.

I’ll keep appending to this post as I work through the rest of the audio.

No such thing as a genetic epidemic

15 May

Since the Autism Omnibus started up again, I’ve been talking about how the Petitioners have pulled the tablecloth out from under the feet of the mercury militia. Its been a mainstay of the militia that there has been an epidemic of autism since the early 1990’s, caused by vaccines, most notably thiomersal and MMR (hence the strapline of mercury militia bible Evidence of Harm – Mercury in Vaccines and the Autism Epidemic and the ‘M’ in SafeMinds (Sensible Action For Ending Mercury -Induced Neurological Disorders).

In fact, lets be clear, SafeMinds believe in an Autism Epidemic, Generation Rescue believe in an Autism Epidemic, the NAA believe in an Autism Epidemic, Jenny McCarthy believes in an Autism Epidemic.

And yet this week, we had petitioners expert witness (i.e. _for the families_) in the autism omnibus destroying the idea of an epidemic. According to him, the number of children throughout the 1990’s/early noughties was in the hundreds.

That’s ‘hundreds’ from a population of 40 million.

He went on to say:

Q: So if the risk is confined to that group, clearly regressive autism, are you assuming then that there is no elevated risk to any other group – any other cases of autism?

A: In the calculations I made, yes.

This is a deliberate strategy on behalf on Petitioners. They want to destroy the idea that all the epidemiological evidence regarding autism and vaccines has shown thus far – that there is no association between autism and any vaccine. They cannot challenge the quality of the science itself so they have moved the goal posts. They are now saying _not_ that vaccines cause autism, but that _some_ vaccines _may_ cause autism in a population of children so tiny it cannot be detected by epidemiology.

That is in direct opposition to the very idea of an autism epidemic which, by definition, must be large and ‘unmissable’ – a tsunami of autism.

Amusingly, the beloved science editor of the Age of Autism blog decided the best way to deal with _his own sides_ expert testimony was to pretend it had never happened.

‘You cannot have a genetic epidemic’ – that’s another mainstay of the mercury militia. The idea that there has been an epidemic is used to support the idea that genes play a small, negligible role in autism (if they play a role at all) because ‘you cannot have a genetic epidemic’ and as we all know there has been au autism epidemic right? Therefore, genees can’t have played any role _in_ that epidemic.

Except that the families in the Autism Omnibus are now relying almost totally on the idea that there never _was_ an autism epidemic.

The genetic role in autism science came to the fore again yesterday when Yale announced a new study that found Genetic links to impaired social behavior in autism:

With the help of Yale’s Autism Center of Excellence, led by Drs. Ami Klin and Fred Volkmar, and many families of individuals with ASD, we have registered a possible association between some of the genes identified in animal studies as controlling affiliative behaviors in ASD.” The strongest statistical findings of the study implicate the prolactin gene, the prolactin receptor gene, and the oxytocin receptor gene in these affiliative behavior deficits.

I haven’t read the paper yet (and I’ll probably need help to understand all the highly technical gene talk) but I’ll probably have nore to say once I have. For now, its interesting that in the week that expert witness for the families in the Autism Omnibus gutted the epidemic hypothesis, yet another study was released linking genes to autism.

Autism Omnibus – Petitioners suggest new prevalence

14 May

As noted by Ms Clark yesterday, petitioners in the current Autism Omnibus hearing are redefining the terms of the so called ‘epidemic’ to proportions that would’ve been unthinkable to any card-carrying mercury militia member at the start of this year.

And as I noted yesterday, not only is the ‘epidemic’ (so long a standard of the vaccine hypotheses) being seriously watered down, so is the very definition of who can claim status as a member of the vaccine-induced-autism club.

And this is not as a result of any utterance by anybody on respondents (HHS) side – this is all direct from the mouths of the Petitioners legal team and their experts. Truly amazing.

The audio files were posted yesterday (please note that despite everything being linked, as of right now, only Day 1 audio files are actually present for download) so I could finally hear some of what was being said for myself. I haven’t listened to the whole thing yet but I wanted to hear more about what I posted yesterday – the fact that Petitioners are now claiming that thiomersal induced autism (assuming it exists at all) accounts for such a small proportion of autism that it is not detectable using epidemiology.

Dr Greenland says (and this is all on Day 1 File 1 – I ain’t going to transcribe it exactly!) that the figures Petitioners are talking about represent a sub-group of regressive autism he terms ‘clearly regressive autism’ (this is also mentioned in his report which I linked to in the post I made yesterday). And of course regressive autism itself is a sub group of autism. According to Greenland, the figures are:

Regressive autism: 28% of autism1.
Clearly regressive autism: 20% of regressive autism
Therefore, clearly regressive autism: (approx) 6% of autism

Now, when we translate this to what the vaccine hypothesis believers like to call ‘proper’ autism (by which I assume they mean classic/low functioning) we get this:

Classical/LF autism: 33% of ASD (based on Fombonne data again).
So, ‘clearly regressive autism’ is 6% of 33% of ASD.

Or in other words, Petitioners ‘clearly regressive autism’ accounts for approx 2% of all ASD.

I can’t say it often enough. This is the expert report of an expert testifying for petitioners. Amazing.

And lets also bear in mind that Greenland is not claiming that *all* ‘clearly regressive autism’ cases are caused by thiomersal. He’s saying that this is the numerical size of the group Petitioners claim *contain* those injured by vaccines, resulting in autism.

So, when we translate that to actual numbers what do we get?

According to CDC, we can estimate that 560,000 children (0 – 21) have an ASD. Using Greenland’s data we can see that:

2% of 560000 = 11,200 people aged between 0 and 21 have ‘clearly regressive autism’.

Based on the data on the front page of census.gov, there are 304,079,911 American citizens as of right now. The child population of which is 25% or 76,019,961.5.

Therefore, according to Petitioners expert witness, the ‘clearly regressive autism’ (aka autism-caused-by-thiomersal) population percentage of the US is *0.015%*.

Tsunami? Hardly.

1] interesting point to note – this is based on Fombonne’s work. Who would’ve thought we’d ever see Fombonne’s data being used to support Petitioners?

PS – maths is not my strong point. Feel free to double check and point out errors/fixes.

Thimerosal on trial- the incredible shrinking epidemic

13 May

The audio recordings of the first day of the thimerosal-only portion of the Autism Omnibus Proceedings hearings are now available here: ftp://autism.uscfc.uscourts.gov/autism/thimerosal.html. They are mp3 files.

Here’s some of what I heard yesterday via telephone and comments on what I think the parents’ lawyers seem to be implying now, maybe you will listen to the same discussion and take away different key points:

A lawyer for the petitioners (Mr. Williams, I think) said, as if a fact: there has been an autism epidemic, and he added that there is no such thing as a “genetic epidemic”.

They know this because no one could “miss” regressive autism in the past. I guess they might have missed other non-regressive autism and other ASDs.

The only kind of regressive autism they are interested in is the “clearly regressive” subtype, which they seem to be saying is about 2% or less of all ASD children born during the 1990s.

Apparently, they are only interested in the children of the “epidemic” era when kids got more thimerosal exposure.

There are so few of their target group that when these kids started to be “added” to the “epidemic” no one could see it happening, and likewise when the exposure to thimerosal dropped of precipitously, even though the numbers of these target group kids must have dropped off precipitously, no one could see that change in the larger epidemiological data.

So the epidemic might continue but it has nothing to do with thimerosal exposure now.

The numbers of “clearly regressive” autistics, however should be obviously diminishing. Because it’s a small group and not all of them “clearly regressed” following a vaccine containing thimerosal. These supposedly thimerosal-damaged clearly regressive kids must be disappearing by now, but maybe they’ve been replaced by kids who “clearly regress” due to another actionable agent. If they regress because of an non-actionable agent, like, say, oxygen or exposure prenatally to mom’s immune system, no one cares. Then logically, if all of the “clear regressing” autistics were caused to regress only by thimerosal, then there should be very few, or none, younger “clearly regressed” autistics in areas where thimerosal is not used for toddler age vaccines now and hasn’t been used in the past few years.

Apparently, they are claiming that thimeosal in vaccines only causes a subset of regressive autism, not including early-onset autism. So apparently there’s no way for a baby who got the birth dose of Hep B to be made autistic, since it can’t “clearly regress” shortly after birth. And if the baby only got the Hep B dose (if preserved by thimerosal), that alone couldn’t cause a regression months later. I think they are only interested in vaccines given right before a toddler regresses, at say age 12 months to 36 months.

Also, it seems that the PSC believes Eric Fombonne’s research is reliable when they want to make a point with it. They used his research to support the numbers of autistics who regress if I recall.

The transcripts will be available eventually (maybe soon), but we don’t know when. I think it would be interesting to compare get them to explain how many of this tiny group of ASD kids also have mitochondrial diseases or disorders. I wonder if they are trying to imply that the rest of the “epidemic” is caused by tuna mercury, chicken mercury or MMR, aluminum, assortative mating or what?

Autism Omnibus and shrinking hypotheses

13 May

The number of people who have made confident assertions about thiomersal causing autism over the last four years or so is astounding.

It’s now 2005…..[W]e should see fewer cases entering the system this year than we did last year.

– David Kirby

if the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis…..total cases among 3-5 year olds, not changes in the rate of increase is the right measure.

– David Kirby

“Late 2006 should be the first time that rates go down” said Handley. “If they don’t, our. hypothesis will need to be reexamined.”

– JB Handley

…I would like to make a virtual wager that within the next 18-24 months scientific evidence will make the thimerosal-autism link a near certainty.

– Richard Deth, March 22, 2006.

All these statements have one thing in common, they promote the idea that mercury (thiomersal in particular) causes autism in either all, or the vast majority of cases.

However, listening to the Autism Omnibus yesterday provided a very interesting change from this perspective:

In some kids, there’s enough of it that it sets off this chronic neuroinflammatory pattern that can lead to regressive autism,” said attorney Mike Williams.

ABC.

Note the new language: ‘some kids’….’regressive autism’…..’can lead’.

It seems the days of ‘all autism is mercury poisoning’ are long gone.

Petitioners presented a very interesting expert witness yesterday – a Dr Sander Greenland from UCLA who is a Professor of Epidemiology.

Dr Greenland argued some strange facts for the PSC but completely in line with this new tack that I can’t even remember being argued in the Cedillo hearing (thiomersal may cause regressive autism in some kids).

Greenland essentially argued that all the current epidemiology regarding autism and thiomersal was not good enough to detect thiomersal causation in regressive autism – this is from his submitted report:

A simple example may clarify this point. If a vaccine is not associated with any type of disorder in the category, we should expect to see the same risk when comparing vaccinated to the unvaccinated. Suppose, however, that in reality the vaccine is associated with a two-fold increase in the risk of a type of disorder in the category, but not associated with any other type. Suppose also that, without the vaccine, the associated type represents only one-tenth (10%) of the disease category, and that the total number of cases in the category would be 100. Then, without the vaccine, the number of cases with the associated type would be 100/10 = 10. With the vaccine, however, the number of cases with the associated type would double, to 20, an excess of 10 cases over the original 10 with the associated type. This excess produced by the vaccine would result in a total of 100+10 = 110 cases over the full category, which is only a 10% increase in the risk of any type in the category. Thus, the risk ratio for getting any type in the category would be only 110/100 = 1.1. Such a small risk ratio cannot be reliably distinguished from 1 by ordinary epidemiologic studies.

In other words, the amount of autism caused by vaccines is in fact too small to be detected by epidemiology. If, of course, it is associated with it at all – a point made later by Dr Greenland:

The brief overview given above supports the idea that the association of MCV (mercury containing vaccine) with autism is small or nonexistent.

But really his point is that if thiomersal does cause autism (and whilst he professes to have ‘no opinion’ on the matter it may be telling that he refers to the idea as a hypothesis throughout his report, not a theory) it causes it in very, very small numbers indeed.

Dr Greenland passed no opinion the validity of the hypothesis itself. Rather, he was there to study epidemiology. We have to respect his opinion even if we disagree with it.

The more telling aspect for me was this sudden conversion from ‘vaccines cause autism’ to this suddenly tiny percentage – so small to be undetectable by epidemiology up to this point. That’s quite a step back. What will become of the Omnibus cases that are not considered’ regressive’? Or the ones (like Michelle Cedillo) who were claimed to be regressive but were, upon viewing the video evidence, clearly not. Are the PSC really throwing cases away?

The Autism Epidemic Meme is Behind Almost All Autism Woo: A Call for Additional Research

13 May

After learning former US president Bill Clinton had indicated he believes that “the number of children who are born with autism [is] tripling every 20 years” (hat tip Orac), an understandable reaction might be to point out his ignorance. Understandable, yes, but I think we are looking at a bigger problem than lack of scientific literacy or political pandering in this case; a problem that is going to have to be addressed in a manner that is clear and generally convincing.

A lot of the discussion in the autism community centers around the anti-vaccination movement. It is true that anti-vaccination could potentially become a major problem for the world as a whole, and it is also true that it is a source of stigma for autistics. Some of us have taken it to be our fight, even though it should probably be the CDC’s or the WHO’s fight, if they were not, as it seems, asleep at the wheel. Nevertheless, I think the persistent autism epidemic meme is a much bigger issue as far as the autism community is concerned. Not only is the notion of an epidemic stigmatizing, but it results in ideas that are more than just theoretically harmful to autistics, such as the idea that autistic adults don’t exist. These ideas will be around regardless of the existence of an anti-vaccination movement.

In my regular blog I have discussed the evidence against the notion of an autism epidemic at length. If I may say so myself, I might have even managed to half persuade a few people from the other side of the debate.
What I want to do here, however, is to essentially critique the evidence I’ve discussed thus far. Let me explain why.

Those of us who are immersed in scientific discussions involving autism are well aware, for example, of diagnostic substitution, of an apparently high prevalence of autism in adults, of the changing characteristics of autistics over time, of regional prevalence differences that resemble time-dependent differences, of the stability of cognitive disability as a whole, of the stability (even the decline) of institutionalization rates, of what went on in the past, and so forth. Taken as a whole, this evidence is overwhelming and convincing to someone such as myself who has studied and perseverated on it for years. Fundamentally, though, it is evidence that has a number of problems: It is too numerous, complex, disjoint and most importantly, lacking in precision; none of it is decisive on its own. We are talking about many bits and pieces of evidence that need to be put together and thought through in order to arrive at the conclusion that there is no such thing as an autism epidemic. I don’t expect someone such as Mr. Clinton to be aware of this evidence, understand it, or think through it, much less be able to analyze some of the publicly available data that is not yet available through the scientific literature.

You see, there’s no such thing as an IOM report on the autism “epidemic.” While I’m personally not that fond of basing my beliefs on what authority tells me I should believe, I think a pronouncement by major authorities on the matter would help inform the general public of the state of the debate and the evidence. For this, however, I believe additional research that specifically addresses the matter in a clear way is needed. Allow me to propose some avenues of future research that could potentially answer the remaining questions once and for all. I encourage readers to propose their own ideas.

1) Replicate Lotter (1967). We know that the prevalence of autism as currently defined is relatively high. We also know that the prevalence of autism as defined in the 1960s was relatively low (4.5 in 10,000). What we don’t know is whether the prevalence of autism ascertained using Lotter’s operationalized criteria and methods is still relatively low in 2008. I think it should be feasible to replicate Lotter’s methodology and criteria today and find out the prevalence, not of DSM-IV autism, but of autism as it was thought of in the past. Without meaning to be disrespectful, this should preferably be done while Lorna Wing is still with us. She claims to know which kinds of children Vic Lotter considered autistic and which he didn’t.

2) Determine the prevalence of autism in adults. This one is non-trivial, as there are some ethical issues to consider, but it seems they will attempt it in the UK. I hope it’s not another case of trying to find how many adults are diagnosed with autism or receiving services under an autism category. This wouldn’t teach us anything new and would just be fodder for David Kirby’s blog. I also hope they don’t assume all autistics must be psychiatric patients, for example. They should find a lot of autistics in the general population, and there is evidence they should find many who might not be diagnosable with autism despite meeting criteria, for various technical reasons. Of course, they also need to look in institutions and group homes, since a ready rebuttal will be that “low functioning” autism must therefore be what’s rare in adults.

3) Determine if regional differences in prevalence are real. When you study administrative databases in some detail, one thing that immediately jumps out is that there are huge disparities in the administrative prevalence of autism between certain regions, be it states, regional centers or counties. I have reasons to believe these differences are not real. If these differences are not real, I’d suggest it would be reasonable to hypothesize that time-based differences in administrative autism prevalence are of the same nature. I have suggested, for example, screening children with mental retardation from different regional centers in California to determine, at the very least, if there are real discrepancies in the prevalence of autism within the population with mental retardation. Another question that needs to be answered is why population density correlates so well with administrative prevalence (independently of things like environmental pollution, as I’ve recently found).

4) Explain the changes with a mathematical model. The plausible mechanisms that explain the rise in diagnoses of autism have been discussed at some length. They might include increased awareness, changes in official criteria, an increased availability of specialists, an increased availability of certain services, changes in cultural beliefs, and so on. I have even discussed the internet as a potential driving force behind increased awareness, particularly in the 1990s. But let’s face it, these are all essentially unproven mechanisms. No one has done a multivariate analysis that gives us a coefficient for each variable. Granted, some things are hard to quantify. It would be a lot like trying to quantify word of mouth. But some of this should be doable.

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Presto Chango

12 May

Now, there’s nothing wrong with making a mistake. Nothing at all. People make mistakes all the time – as I saw on the back of a window cleaners van the other day – ‘guano happens’.

For a trivial mistake (spelling etc) its easy to change things on a blog. I can simply edit and re-save the post. I don’t need to tell anyone my Bluto sized fingers have typed ‘teh’ instead of ‘the’ again. I can just change it and republish.

However, sometimes, you make a mistake that is rather more important. A mistake that changes the factual interpretation _and_ the tone of a post. These should be altered _and_ a little note be made close to the alteration to point out the error and the fact its fixed. Trying to get away with making such large scale errors and hoping no one notices is bad form.

If one is a journalist – a professional writer – you would expect the notification as a matter of course. Don’t journalists pride themselves on their accuracy and attention to detail?

So it was something of a surprise to see that the article Sullivan discussed written by David Kirby had undergone a mysterious and totally unremarked upon alteration.

This (click for larger image and then use your browsers ‘back’ button to return here after viewing) is the original post David made on the Huffington Post. The page was recovered from Google Cache. As you can see, this contains the erroneous ‘34,000’ figure and all that flows from it. The maths error that Sullivan noted.

However, visiting the Huffington Post post today reveals the following:

.

(Again, click for bigger).

As we can see, the post has undergone very significant change of a key part of important factual information. With no (that I can see) notification that the data has been altered. I took a screen shot of the entire page as of 09:43 on Mon 12th May 2008 and couldn’t see such a notification. Maybe someone else can see one?

Tut tut.

However, even more curiously, the same article David posted at the Age of Autism blog still contains the error.

(Again, click for bigger).

Why? Are AoA readers less interested in facts? Is David too busy packing for his trip over here in June (which I am _very_ much looking forward to by the way)?

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